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非糖尿病血液透析患者胰岛素抵抗的患病率及相关性:越南的一项描述性分析横断面研究

Prevalence and Association of Insulin Resistance in Non-Diabetic Hemodialysis Patients: A Descriptive-Analytic Cross-Sectional Study in Vietnam.

作者信息

Hoang Bui Bao, Nguyen Khoa Ngoc Van, Ngo Trang Thi Khanh

机构信息

Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.

Department of Internal Medicine, Quang Nam General Hospital, Tam Ky City, Vietnam.

出版信息

Indian J Nephrol. 2025 May-Jun;35(3):368-372. doi: 10.25259/IJN_31_2024. Epub 2024 Jul 22.

DOI:10.25259/IJN_31_2024
PMID:40352876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12065613/
Abstract

BACKGROUND

Patients with chronic kidney disease (CKD) experience high mortality rates from cardiovascular disease (CVD). Insulin resistance (IR) is a frequent complication of CKD and is associated with poorer cardiovascular outcomes. This study investigates the prevalence and associations of IR in hemodialysis (HD) patients.

MATERIALS AND METHODS

A descriptive-analytic cross-sectional study was conducted on 103 HD patients. We used the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI) to measure IR. We examined potential associations between IR and the following factors: age, gender, etiology of kidney failure, BMI, waist circumference, blood lipids, hemoglobin concentration, uric acid, and duration of HD.

RESULTS

The prevalence of IR, as measured by HOMA-IR, was 61.2%, and by QUICKI, it was 48.5%. Age, gender, etiology of kidney failure and increased waist circumference did not significantly influence IR. A significant associations were observed between IR and higher BMI, anemia, dyslipidemia, and longer duration of HD therapy. Interestingly, the HOMA-IR and QUICKI indices correlated for most factors except total cholesterol, LDL-C, and uric acid.

CONCLUSION

This study found a high prevalence of IR in HD patients, with 61.2% identified by HOMA-IR and 48.5% by QUICKI. We confirmed significant associations between IR and BMI, anemia, dyslipidemia, and duration of HD therapy in this population.

摘要

背景

慢性肾脏病(CKD)患者心血管疾病(CVD)死亡率很高。胰岛素抵抗(IR)是CKD常见的并发症,且与较差的心血管预后相关。本研究调查血液透析(HD)患者中IR的患病率及相关性。

材料与方法

对103例HD患者进行描述性分析横断面研究。我们使用胰岛素抵抗稳态模型评估(HOMA-IR)和定量胰岛素敏感性检查指数(QUICKI)来测量IR。我们检查了IR与以下因素之间的潜在关联:年龄、性别、肾衰竭病因、体重指数(BMI)、腰围、血脂、血红蛋白浓度、尿酸和HD时长。

结果

以HOMA-IR测量的IR患病率为61.2%,以QUICKI测量的为48.5%。年龄、性别、肾衰竭病因和腰围增加对IR没有显著影响。观察到IR与较高的BMI、贫血、血脂异常以及较长的HD治疗时长之间存在显著关联。有趣的是,除总胆固醇、低密度脂蛋白胆固醇(LDL-C)和尿酸外,大多数因素的HOMA-IR和QUICKI指数具有相关性。

结论

本研究发现HD患者中IR患病率很高,HOMA-IR确定的患病率为61.2%,QUICKI确定的为48.5%。我们证实在该人群中IR与BMI、贫血、血脂异常和HD治疗时长之间存在显著关联。

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本文引用的文献

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Diabetes Care. 2022 Aug 1;45(8):1863-1872. doi: 10.2337/dc22-0202.
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Prediabetes and insulin resistance in a population of patients with heart failure and reduced or preserved ejection fraction but without diabetes, overweight or hypertension.心力衰竭患者人群中存在空腹血糖受损和胰岛素抵抗,这些患者射血分数降低或保留,但无糖尿病、超重或高血压。
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Association of Longitudinal Trajectories of Insulin Resistance With Adverse Renal Outcomes.胰岛素抵抗纵向轨迹与不良肾脏结局的关联
Diabetes Care. 2022 May 1;45(5):1268-1275. doi: 10.2337/dc21-2521.
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Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review.胰岛素抵抗在慢性肾脏病患者中的作用及治疗:综述。
Nutrients. 2021 Dec 2;13(12):4349. doi: 10.3390/nu13124349.
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Severe refractory TAFRO syndrome requiring continuous renal replacement therapy complicated with infection in the lungs and myocardial infarction: an autopsy case report and literature review.需要持续肾脏替代治疗的严重难治性TAFRO综合征并发肺部感染和心肌梗死:一例尸检病例报告及文献复习
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